Category: Culture

Was mental health care in the past as barbaric as we might think? John McGowan finds out about some innovators of the Victorian era.

What do we think of mental health treatments in the 19th century? My own mind conjures up shocking images of asylums, like the one where people were caged up in the film Amadeus, or the ‘Madhouse’ of Bedlam in Hogarth’s A Rake’s Progress(pictured above). Both were actually set in the 18th Century but it’s all folded into a general impression of imprisonment with some torture thrown in. (Bedlam, incidentally, is a corruption of the name of The St. Mary of Bethlehem Hospital in London which still exists, though we now know it as The Bethlem.)

One of the things we’re proud of on the Clinical Psychology Doctorate here at Salomons is our teaching unit on service user and carer perspectives. One of the speakers recently had to cancel at short notice. I (Anne) had the idea of showing the trainees a service user/survivor-recommended film instead, and then discussing the issues raised. As I often do, I turned to Twitter for suggestions.

And boy did I get them! So many that they could keep me occupied for the next year. To help organise and review all this material I turned to service user/survivor activist and ‘half-dog’ Twitter stalwart, Maddog (@maddoggie2) whom I’ve known for a long time and who is currently mentoring a trainee research project with me. A self-confessed film buff who had made many of the suggestions, she has generously collected together everyone’s recommendations and provided her own commentary on each.

Here they are. What’s missing? What have the good folk of Twitter missed? Have they picked something you love? Or that you hate? We’d love to hear from you in the comments below.

Films and videos recommended by service users and survivors on Twitter.

Reviewed by Maddog

Cathy Come Home. Ken Loach from the 1960’s. A seminal film about homelessness.

Family Life. Ken Loach’s again, this time from the 1970’s. A film about a young woman’s struggle with parental pressures to accept her lot as a working class woman. Her subsequent descent into the psychiatric system ultimately destroys her.

I, Daniel Blake. Ken Loach is still going at the age of 80, and his most recent film (out this month) depicts the brutal reality of today’s welfare system. A must-see for every health and social care professional.

In the Real. Produced by the Bristol Hearing Voices Network, this film shows the gritty reality of living with a diagnosis of psychosis, schizophrenia or schizoaffective disorder. A refreshing change from sanitised ‘recovery’ stories. My joint top recommendation with Breakdown (below).

Shine. Geoffrey Rush’s beautiful portrayal of parental and educational pressures leading to madness. It respects and honours the experience, offering clear context.

Gaslight. A 1940’s film about a woman whose husband slowly manipulates her into believing that she is going insane, for his personal gain (it would resonate with aspects of the Helen and Rob storyline in The Archers). This film gave its name to the phenomenon of ‘gaslighting’.

Frances. A film based on the real life story of the 1930’s movie star Frances Farmer who refused to conform to parental and film studio expectations of women, and ended up being forcibly hospitalised.

Terminator 2: Judgement Day. An unexpected choice maybe but bear with me. The second film in the Terminator series: a cyborg attempts to kill the future leaders of the human resistance against a computer/machine takeover of the world: a mother and her son. A second cyborg attempts to save them. The key scenes much loved by survivor activists involve a disbelieving psychiatrist whose scales fall from his eyes when he is confronted with the reality of the mother’s story. She also breaks his arm and sticks a needle in his neck before making an epic escape from a high secure hospital. The central message for mental health workers is: believe what your patient says to you or that’s what could happen. I’d be willing to demonstrate with any willing ‘volunteer’!

Life is Sweet. Mike Leigh’s funny and poignant exploration of family life with one member struggling with bulimia in the aftermath of life-threatening anorexia.

An Angel at my Table. True story biopic by Jane Campion about the life of writer Janet Frame, showing her descent into long hospitalisations, and her ultimate survival.

The War Zone. Tim Roth’s 1999 directorial debut with a hard hitting drama portraying sexual abuse in a family.

Ring (Japanese edition). A psychological horror film notable for a scene depicting a character moving from one reality to another. A woman on the TV actually climbs out through the TV screen. This is useful imagery in understanding what it can be like for voice hearers who experience their voices coming from the TV.

Taking over the Asylum. A highly acclaimed 1990’s TV series set in a Scottish acute psychiatric unit and focusing on the lives and struggles of the patients. The writer Donna Franceschild had direct experience which shows in the writing. One character is especially notable for a sensitive and unusually rounded portrayal of experience diagnosed as OCD.

One Flew Over the Cuckoo’s Nest. Classic film often derided by psychiatrists and nurses for ‘damaging the reputation’ of electroconvulsive therapy (ECT). However for me what’s central to the film is the portrayal of the everyday emotional brutality, seen particularly in ‘Billy’s’ storyline. Staff nurse Ratched is expertly played not as a monster, but as a person who truly believes that her monstrous actions are in the patients’ best interests.

Poppy Shakespeare. A 2008 film based on the award winning book by Clare Allan about the lives of patients in a North London mental health day hospital.

The Hours. Three generations of women connected by the Virginia Woolf novel Mrs Dalloway struggle for meaning in their lives and with mental distress and suicide.

Gattaca. A visually elegant sci-fi film set in a eugenic future where babies conceived outside of the eugenics programme are second class citizens serving the genetic elite. The film focuses on two characters struggling to find their places in society, one genetically ‘flawed’ and the other genetically ‘perfect’ but paralysed by an accident.

Sling Blade. A poignant film about a man with a learning disability released from hospital, his acceptance around an awkward community, friendship with a lonely boy and his sacrifice to protect the boy from family violence.

Requiem for a Dream. A bleak and gripping psychological drama about different forms of drug addiction.

Donovan Quick. A retelling of the Don Quixote story set in present day Scotland by ‘Taking over the Asylum’ writer Donna Franceshild.

Science and the Swastika. A television series examining science and morality during the Third Reich, and the practice of eugenics and euthanasia in Nazi occupied Europe.

Nuts. A 1980’s film with Barbara Streisand as a sex worker abused as a child, now accused of murder and fighting against an insanity plea. It’s very Hollywood but worth a view.

Asylum. 2005 Film set in the 1950’s which depicts a psychiatrist’s wife’s rebellion against gender expectations, sexual obsession and psychological manipulation by a psychiatrist played by Ian McKellen.

Good Will Hunting. Film about a young, unrecognised genius using therapy sessions to re-evaluate his past and his relationships, and to think about his future. The therapist is played by Robin Williams.

These are films I’m unfamiliar with so can’t review but were recommended by members of the Recovery in the Bin group:

Beyond popular (and broadly mainstream) films like the ones above, there are also a large number of films from a variety of other sources available on platforms like YouTube and Vimeo. Here is a selection of ones I’d argue are essential and should be part of the core curriculum in mental health education and training. Be warned, some of them take strong positions and really aren’t comfortable viewing.

Those who advocate psychological therapies are good at being critical. Especially when it comes to medicine. But, argue Huw Green andLeigh Emery psychology-types may need to be a bit more sceptical about what’s done in their name?

As those who check in regularly with this blog know we do occasionally manage a bit of culture (films and books), when it’s related to psychology and mental health. It’s a great pleasure therefore, not only be able to talk about a new novel that goes into both areas, but to interview the author.

Beth Miller is a novelist who used to be a psychologist (she’s got a doctorate that doesn’t make it to her book covers). Her most recent novel The Good Neighbour is part domestic drama, part psychological thriller, part exploration of some scary places in the human psyche. It starts in a nice street, in a nice town (Hove, actually), with nice neighbours. We initially see this through the eyes of Minette, a rather bored stay-at-home mum, who makes friends with Cath: older, feistier and coping incredibly with her son Davey’s illness. Under Cath’s spirited influence Minette also becomes a different sort of friendly with the hunky fellow down the road.

The job of interviewer isn’t the easiest here as the story is a craftily put together teaser where what’s going on is revealed bit by bit. Spoiling would be bad form, but suffice to say that the niceness lasts for about as long as the veneer in Blue Velvet, and things quickly get complicated. Beth dropped into speak to us as part of a ‘blog tour’, a modern phenomenon that was, I confess, new to me. We’re the only psychology/mental health blog to nab her though, and we were pleased to be able to ask her some questions about psychology, mental health in fiction and what lies beneath nice neighbourhoods.

You ‘used’ to be a psychologist. Putting aside whether psychology is something you can ever truly leave (like the Catholic Church or the Mafia), why did you end up writing fiction?

Because it was something to keep me occupied while I was in the witness protection programme, following my middle-of-the-night escape from psychology. OK, not really. I have always written, alongside my other work, and gradually the need to write became more pressing, until it took centre-stage and I stopped doing my other work.

How does your background in psychology influence your writing?I don’t consciously use the psychology I’ve learned in my novels, but I think it’s there, bubbling under the surface. I guess I retain the essential curiosity that propelled me into psychology in the first place. Like many people, I’m fascinated about what goes on behind the public faces of complicated people. Yes, I accept that curiosity is another word for nosiness. If I see a couple having an argument, for instance, I really want to know what it’s about, and have been known to loiter near them, risking their wrath, to find out.

One of your characters is identified as having pretty serious mental health problems. However, you don’t really play that ‘mentally ill’ aspect up. I wondered why if you thought of making more of it?

Once you give someone in a story a label, you create expectations about that character, which then can limit their options. Maybe the same is true in real life? Of course, having expectations can be very useful, in that others know, or at least think they know, how to react to someone with a particular label. But I didn’t want to direct the reader as to how they should think and feel about this character (whom I’ll call Chris, to save me having to type ‘this character’ every time). I didn’t want it to be ‘this is a story about Chris who has X diagnosis.’ Although Chris does have some psychological problems, I was interested not so much in the name or origin of the problems, but more in the unique ways Chris deals with them. In general, I think I’m interested in the unique way we all deal with our problems, whether we call them mental health problems or not. Fiction has a tendency to treat people with mental health problems as either unremittingly bad, or as saintly and wise. I hope I have portrayed a more real and nuanced person.

And I didn’t want it to be an ‘issues’ book. One of the other characters says something like, just because someone’s been diagnosed with something doesn’t mean that you necessarily understand them any better. That’s how I feel. I don’t think labels necessarily help you understand, though they sometimes feel as if they do.

The Good Neighbour explores the mundaneness of everyday life and also the terrible things that people can sometimes do to one and other. What drew you to both types of material?

Good question! I am very interested in the layers of extraordinariness that lie just under the surface of everyday life. How you can just be going about your usual day and then one new little thing happens: someone falls down the stairs, or a car breaks down, or an unexpected letter arrives, and the whole of a person’s life takes a different path to the one it was heading down. And I am also very interested in the terrible things people do to each other – in fact, I’m drawn towards exploring them out of grim fascination. I want to know why someone does the terrible and seemingly inexplicable thing they do. Because presumably they have reasons, however hard those might be for us to accept, and however unaware they might be of them. It seems to me that in their different ways, psychology and fiction are both quite useful methods for going inside a person’s head and trying to figure out why they do what they do.

Depending on whom you talk to we’re either in one of the most violent and scary periods in human history or in one of the safest. Should we be worrying more about our neighbours?

I don’t think so. I tend to wander round assuming people are nice until I’m proved wrong. I think that’s at least as good a principle as assuming everyone’s awful. As the book is called The Good neighbour, I ought to say on the record that of course all my neighbours are lovely (though I believe some people are less lucky).

The Big Alfie and Annie Rose Storybook ambushed me the other day. It was sitting in the window of a charity shop while I was on my way somewhere. Sentimentality can get you when you’re least expecting it, especially where the children’s author Shirley Hughes is concerned. One minute you’re thinking about what you need from the chemist, and the next about how long it was since you’ve read to your kids, and why the little pests have to grow up so quickly. But they’re off to chat to their mates online and don’t care that you are left clasping a book with a hopeful expression. It helps – a bit – to know that you’re far from the first to go down this road. Literature and modern culture abound with examples. From Peter Pan to Toy Story, it’s clear that leaving behind childish things can be painful; sometimes for the one growing up, but more often for those around them. Is it possible to watch Jessie the cowgirl being thrown out by her owner, without reaching for the tissues?